Contract Pharmacy Details

DRUG MART SOLUTIONS LLC
DSH330024 THE MOUNT SINAI HOSPITAL

Covered Entity Details

Entity Name

THE MOUNT SINAI HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH330024

Entity Address

ONE GUSTAVE L. LEVY PLACE
NEW YORK, NY 10029

Medicare Provider Number

330024

Participating Start Date

7/1/2004

Last Recertification Date

8/12/2024

Pharmacy Details

Pharmacy Name

DRUG MART SOLUTIONS LLC

Pharmacy Address

D/B/A QUALITY RX
1611 UNIVERSITY AVENUE
BRONX, NY 10453

Pharmacy Comments

Contract Details

Approval Date

7/14/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/9/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

KENNETH DAVIS, CEO
(212) 659-8888

Contract Pharmacy Representative

Charles Rabinovich, Director of Corporate Operations
(800) 490-1755

Signed By Date

7/14/2016

340B Drug Pricing Program Database